Neuropsychological assessment of Chilean children with a history of extreme prematurity: An exploratory study.

This study was conducted to explore the neuropsychological abilities of premature Chilean children. Two groups (Premature and Control, 10 children each, age ranging from 5 to 7.11) were established based on weeks of gestation and/or weight at birth. Relevant variables such as age, gender, schooling, and socioeconomic level were matched considering Chile's particular demographic context. Children were assessed by means of the Evaluación Neuropsicológica Infantil (ENI-2) battery, measuring nine cognitive domains encompassing 23 subscales. In turn, subscales are grouped in two scales: Cognitive Functions and Executive Functions. Since the ENI-2 battery provides norms for Spanish-speaking children, obtained data were inspected both for possible between-group differences and either adjustment or deviance from average range. Results show that premature children perform within typical ranges in all subscales except for Visual attention and Graphic fluency. When comparing both groups, some differences emerged. These differences are most prominent in subscales related to visuoperceptual skills. Interestingly, between-group linguistic performance is very similar. The point is made that early linguistic interventions conducted on premature children seem to positively impact on oral language expression and comprehension. On the contrary, early interventions focused on visuospatial abilities did not seem to attain the same impact. This may be a consequence of visual-information processing problems derived from cortical dorsal stream's vulnerability, which literature correlates with prematurity.

Comparison between vaginal and sublingual misoprostol 50 µg for cervical ripening prior to induction of labor: randomized clinical trial.

OBJECTIVE: To compare the effectiveness and safety of sublingual versus vaginal misoprostol on improving the Bishop score after 6 h of administration. METHODS: Randomized clinical trial which includes pregnant women in gestational ages from 32/0 to 41/6, with indication of induction of labor with misoprostol. Bishop score was assessed at the time of induction and 6 h after administration of 50 µg misoprostol. Analysis was made over difference in mean Bishop score of 2 points, using a standard deviation of 2, with 90% power, reaching a 95% confidence interval. RESULTS: 102 patients were studied, 51 received sublingual misoprostol, and 51 received vaginal misoprostol. There was a statistically significant difference in cervical modifications in global terms regardless of the administration route at 6 h (P < 0.05). When analyzing each group, there was no significant difference for the mean and standard deviation for Bishop score for sublingual and vaginal route (P = 0.761). There was no significant difference in terms of mode of delivery, Apgar score, cord pH, nor in the presence of complications. CONCLUSION: There is no statistically significant difference in terms of administration route for cervical ripening using misoprostol 50 µg, whether it was sublingual or vaginal. TRIAL REGISTRATION NUMBER: NCT02732522. Registry website: https://clinicaltrials.gov/ .